Provider Demographics
NPI:1346798139
Name:JAGMINAITE, EVELINA (MAAT)
Entity Type:Individual
Prefix:
First Name:EVELINA
Middle Name:
Last Name:JAGMINAITE
Suffix:
Gender:F
Credentials:MAAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 CANAL ST STE 201
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-6434
Mailing Address - Country:US
Mailing Address - Phone:504-525-2366
Mailing Address - Fax:504-525-7525
Practice Address - Street 1:2626 CANAL ST STE 201
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6434
Practice Address - Country:US
Practice Address - Phone:504-525-2366
Practice Address - Fax:504-525-7525
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2140078Medicaid